<b>Wide-Field En Face Swept-Source Optical Coherence Tomography Features of Extrafoveal Retinoschisis in Highly Myopic Eyes</b>

Xiao, Wei; Zhu, Zhuoting; Odouard, Capucine; Xiao, Ou; Guo, Xinxing; He, Miao

doi:10.1167/iovs.16-20607

Cited by 12 publications

(6 citation statements)

References 23 publications

(30 reference statements)

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“…[2] In this article, we reported two cases of high myopia with retinoschisis near the vascular arcade with abnormal blood vessels, which have rarely been reported previously. Similar to previously reported cases, [4,5] the location of the abnormal blood vessels was around the arcade rather than the macular area. The nature of this vessel abnormality is still unclear.…”

Section: Discussionsupporting

confidence: 88%

“…[4] According to the location of the retinoschisis, it can be divided into foveal retinoschisis (myopic macular retinoschisis) and retinoschisis away from the fovea, with paravascular retinoschisis being the main form of retinoschisis away from the fovea. [5] Previous literature has shown that paravascular retinoschisis might be a precursor to myopic macular retinoschisis. [6,7] Its mechanism is not well understood, but most authors believe that the combination of vitreoretinal traction, posterior scleral staphyloma, and retinal degeneration in the posterior pole contributes to the development and progression of retinoschisis.…”

Section: Discussionmentioning

confidence: 99%

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Treatments of retinoschisis with multiple abnormal blood vessels in high myopia: a case report

Xu,

Wei,

Dong

et al. 2023

Preprint

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Background Retinoschisis is not an uncommon complication in patients with high myopia. And paravascular retinoschisis might be a precursor to myopic macular retinoschisis. However, few cases of retinoschisis near the vascular arcade with abnormal vessels have been reported. Such abnormal vessels may cause vitreous hemorrhage, and vision is severely impaired as the disease progresses. At the same time, due to the small number of reported cases, opinions on the treatment of these abnormal blood vessels are not unified. In this article, we reported two cases of high myopia with retinoschisis near the vascular arcade with abnormal blood vessels, and different treatments of three eyes of retinoschisis with abnormal blood vessels near the arcade in high-myopic patients to provide new evidence for the understanding of the diagnosis and treatment of this disease. Case presentation: This study included three eyes of two patients with high myopic retinoschisis with or without foveal detachment accompanied by retinoschisis at the vascular arcade with abnormal retinal vessels. Both patients were middle-aged women with high myopia. The eye with macular retinoschisis with fovea detachment was treated with vitrectomy combined with fovea-spared inner limiting membrane peeling and air tamponade, and the other two eyes were treated with focal retinal laser photocoagulation. The abnormal vessels in all three eyes completely regressed within 1 to 3 months after treatment. Morphological changes in the abnormal retinal vessels after the treatment were evaluated by color fundus photography (CFP), optical coherence tomography (OCT), optical coherence tomography angiography (OCTA) and fundus fluorescein angiography (FFA). Conclusions In this article, we report some clinical manifestations of retinoschisis with multiple abnormal vessels near the vascular arcade in high myopia and show that both laser and vitrectomy treatment can successfully regress abnormal vessels.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Treatments of retinoschisis with multiple abnormal blood vessels in high myopia: a case report

Xu,

Wei,

Dong

et al. 2023

Preprint

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“…Similar results were found in the study of Ruão et al [23], who found extrafoveal retinoschisis in 23.9% of their patients' eyes. However, Xiao et al reported that the most prevalent type of extrafoveal retinoschisis in their sample was the inner type [43], although they selected a sample of patients with a previous diagnosis of extrafoveal retinoschisis, which may explain the difference.…”

Section: Discussionmentioning

confidence: 97%

Does PLEX® Elite 9000 OCT Identify and Characterize Most Posterior Pole Lesions in Highly Myopic Patients?

Arlanzon-Lope

Campos

Fernandez-Bueno

et al. 2023

JCM

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High myopia (HM) is defined as an axial length (AL) ≥ 26 mm that may result in various pathologies that constitute pathologic myopia (PM). The PLEX® Elite 9000 (Carl Zeiss AC, Jena, Germany) is a new swept-source optical coherence tomography (SS-OCT) underdevelopment that allows wider, deeper and more detailed posterior-segment visualization; it can acquire ultra-wide OCT angiography (OCTA) or new ultra-wide high-density scans in one image. We assessed the technology’s ability to identify/characterize/quantify staphylomas and posterior pole lesions or image biomarkers in highly myopic Spanish patients and estimate the technology’s potential to detect macular pathology. The instrument acquired 6 × 6 OCTA, 12 × 12 or 6 × 6 OCT cubes, and at least two high-definition spotlight single scans. A hundred consecutive patients (179 eyes; age, 51.4 ± 16.8 years; AL, 28.8 ± 2.33 mm) were recruited in one center for this prospective observational study. Six eyes were excluded because images were not acquired. The most common alterations were perforating scleral vessels (88.8%), classifiable staphyloma (68.7%), vascular folds (43%), extrafoveal retinoschisis (24%), dome-shaped macula (15.6%), and more uncommonly, scleral dehiscence (4.46%), intrachoroidal cavitation (3.35%), and macular pit (2.2%). The retinal thickness of these patients decreased, and the foveal avascular zone increased in the superficial plexus compared with normal eyes. SS-OCT is a novel potent tool that can detect most main posterior pole complications in PM and may provide us with a better understanding of the associated pathologies; some pathologies were identifiable only with this new kind of equipment, such as perforating scleral vessels, which seem to be the most common finding and not so frequently related to choroidal neovascularization, as previously reported.

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“…The development of OCT allows better visualization of detailed alterations and early insights of MTM, which can help not only the classification and definition of the disease, but also the assessment of the natural course [ 85 ]. Using widefield SS-OCT, researchers found that coexisting extrafoveal retinoschisis were frequently identified in the inferotemporal area and were related to retinal vessel, microfolds, microbreaks, and staphyloma [ 86 ]. Recently, a new classification system of MTM based on OCT images has been proposed: the retinal stages 1–4 are presented along the vertical axis emphasizing the evolution in the layers perpendicular to the retinal plane; the foveal stages a–c are presented along the horizontal axis emphasizing the evolution in the layers tangential to the retinal plane; the occurrence of an outer lamellar macular hole or epiretinal abnormalities is recorded as “O” or “+” [ 85 ].…”

Section: Oct and Octa For The Assessment Of Pathology In High Myopesmentioning

confidence: 99%

Advances in OCT Imaging in Myopia and Pathologic Myopia

Zheng

Foo

et al. 2022

Diagnostics

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Advances in imaging with optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) technology, including the development of swept source OCT/OCTA, widefield or ultra-widefield systems, have greatly improved the understanding, diagnosis, and treatment of myopia and myopia-related complications. Anterior segment OCT is useful for imaging the anterior segment of myopes, providing the basis for implantable collamer lens optimization, or detecting intraocular lens decentration in high myopic patients. OCT has enhanced imaging of vitreous properties, and measurement of choroidal thickness in myopic eyes. Widefield OCT systems have greatly improved the visualization of peripheral retinal lesions and have enabled the evaluation of wide staphyloma and ocular curvature. Based on OCT imaging, a new classification system and guidelines for the management of myopic traction maculopathy have been proposed; different dome-shaped macula morphologies have been described; and myopia-related abnormalities in the optic nerve and peripapillary region have been demonstrated. OCTA can quantitatively evaluate the retinal microvasculature and choriocapillaris, which is useful for the early detection of myopic choroidal neovascularization and the evaluation of anti-vascular endothelial growth factor therapy in these patients. In addition, the application of artificial intelligence in OCT/OCTA imaging in myopia has achieved promising results.

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Wide-Field En Face Swept-Source Optical Coherence Tomography Features of Extrafoveal Retinoschisis in Highly Myopic Eyes

Cited by 12 publications

References 23 publications

Treatments of retinoschisis with multiple abnormal blood vessels in high myopia: a case report

Treatments of retinoschisis with multiple abnormal blood vessels in high myopia: a case report

Does PLEX® Elite 9000 OCT Identify and Characterize Most Posterior Pole Lesions in Highly Myopic Patients?

Advances in OCT Imaging in Myopia and Pathologic Myopia

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